Vet-standard HHHHHMM scale · Cat-specific · Compassionate
Cat Quality of Life Calculator
Caring for a cat near the end of life is one of the hardest things a pet parent can face. This assessment helps you reflect gently, without judgment, on how your cat is really doing so you can make informed and loving decisions with your veterinarian.
This is not a pass/fail test. There are no perfect answers and no single number can decide for you. Your observations, your cat's history, and your veterinarian's guidance belong together.
If age context would help, you can also calculate your cat's age in human years.
Gentle reflection dashboard
HHHHHMM total
42/70
Watch closely
Cat-specific signals
20/30
Grooming · hiding · purring
Facial pain score
0/10
Feline Grimace Scale
Continue gentle monitoring
Repeat this assessment when appetite, grooming, hiding, breathing, or mobility changes.
Step 1
Assess your cat's quality of life
Use the sliders as a structured way to notice patterns. A lower score is not a failure; it is a signal that your cat may need more comfort support.
Pain control, breathing comfort, and whether discomfort seems manageable.
Pain seems hard to controlSome change or mixed signsComfortable and breathing normally
Interest in food, ability to eat, and whether support feeding is needed.
Refusing foodSome change or mixed signsEating willingly
Drinking, moist gums, skin elasticity, and whether fluids are needed.
Likely dehydratedSome change or mixed signsHydration seems steady
Clean coat, litter box comfort, and ability to stay dry and clean.
Cannot stay cleanSome change or mixed signsStaying clean
Interest in people, favorite places, affection, toys, and normal routines.
Withdrawn or distressedSome change or mixed signsStill engaged
Ability to stand, walk, reach food/water/litter, and rest comfortably.
Needs major helpSome change or mixed signsMoves comfortably
Whether recent good days are still more common than difficult days.
Bad days dominateSome change or mixed signsGood days dominate
Today's assessment
Quality of life dashboard
Supportable with close watching
Today's answers suggest Luna's comfort is still present, with some areas worth watching closely.
HHHHHMM
42/70
The HHHHHMM score suggests hospice or comfort care may continue with close monitoring.
Composite
43/70
Includes cat-specific signs
7-criteria score shape
Hurt7/10
Hunger6/10
Hydration6/10
Hygiene6/10
Happiness6/10
Mobility5/10
More good days6/10
Signals worth discussing
- FGS score 0/10 does not show clear facial pain signs today.
Step 2
Cat-specific comfort signals
Cats often hide pain. Grooming, hiding, and comfort response can reveal changes before a dramatic symptom appears.
Grooming behavior
Is your cat grooming like they usually do?
Hiding behavior
Is your cat hiding more than usual?
Purring
Does your cat still purr or respond to comfort?
Step 3
The Feline Grimace Scale
The Feline Grimace Scale looks at five facial action units that can change when a cat is in pain. Watch your cat at rest, avoid disturbing them, and use this as a conversation starter with your veterinarian.
Current facial score
0/10
Scores around 4 or higher suggest pain signs that deserve veterinary attention, especially if they match appetite, mobility, or hiding changes.
Orbital tightening
0Muzzle tension
0Whisker position
0Head position
0Daily tracker
Good days vs. difficult days
A simple calendar can make patterns visible during an emotional time. Start early when a serious illness or age-related decline begins, then bring the pattern to your vet.
Recent days
23G
24M
25G
26D
27M
28G
29D
30D
1M
2G
3D
4D
5M
8M
G = GoodM = MixedD = Difficult
Trend view
Patterns over time
Good
4
Recent 14 days
Difficult
5
Recent 14 days
Mixed
5
Recent 14 days
Difficult days are outnumbering good days
Over the past 14 days, difficult days (5) are outnumbering good days (4). This is a meaningful pattern to bring to your veterinarian.
Vet conversation
Questions to bring with you
- Based on this assessment, how would you describe my cat's comfort today?
- Is my cat likely in pain, and what signs should I watch for at home?
- Which changes would mean I should call you the same day?
- Can we make food, water, litter, and resting places easier to reach?
HHHHHMM scale
What is the HHHHHMM quality of life scale?
The HHHHHMM scale is a veterinary quality-of-life framework created by veterinary oncologist Dr. Alice Villalobos. It organizes the conversation around Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. Each area receives a 0 to 10 score, creating a 70-point picture that helps families and veterinarians discuss comfort more concretely.
Scores above 35 are commonly interpreted as a supportable quality-of-life range for continued care or hospice monitoring. Scores below 35 deserve closer attention, and very low scores should prompt a timely veterinary conversation. The number is a guide, not a verdict.
Hurt
Pain control, breathing comfort, and whether discomfort seems manageable.
Hunger
Interest in food, ability to eat, and whether support feeding is needed.
Hydration
Drinking, moist gums, skin elasticity, and whether fluids are needed.
Hygiene
Clean coat, litter box comfort, and ability to stay dry and clean.
Happiness
Interest in people, favorite places, affection, toys, and normal routines.
Mobility
Ability to stand, walk, reach food/water/litter, and rest comfortably.
More good days
Whether recent good days are still more common than difficult days.
Hidden pain in felines
Why cats are different
Cats evolved as both predators and vulnerable small animals, so hiding weakness can be protective. That instinct can make pain look like quietness, distance, or changed routines instead of dramatic crying. Compared with many dogs, cats may withdraw, stop grooming, sleep in unusual places, avoid touch, or change their face and posture before they make obvious sounds.
The Feline Grimace Scale helps by focusing on ears, eyes, muzzle, whiskers, and head position. It should be used while your cat is calm and undisturbed. It is especially useful when combined with the daily observations you already know best: grooming, hiding, appetite, litter-box access, and whether familiar comfort still feels welcome.
Cat-specific warning signs
- Grooming stops or the coat becomes unusually unkempt.
- Hiding increases or your cat avoids people and familiar resting spots.
- Purring, greeting, or comfort-seeking changes noticeably.
- Breathing becomes rapid, labored, or open-mouthed.
- Food, water, litter-box use, or mobility changes cluster together.
Home hospice
Comfort-focused care at home
What hospice means
Home hospice care shifts the goal from cure to comfort. A veterinarian may help with pain medicine, appetite support, hydration, nausea control, mobility support, and a clear plan for what to do if symptoms change.
How to talk to your vet
Bring your HHHHHMM score, facial pain score, and good-day log. Ask what can still be improved, what decline may look like, and which signs mean comfort is no longer being maintained.
When is it time?
There may not be a single perfect moment. Many families look for patterns: pain that cannot be controlled, breathing distress, refusal to eat, loss of favorite routines, or difficult days consistently outnumbering good days.
Nutrition support
If appetite is changing, ask your vet about nausea, pain, dental comfort, appetite support, or feeding strategies. You can also calculate nutrition needs for a senior or ill cat with the calorie calculator.
Support resources
Coping with the decision
Anticipatory grief is real. Many people begin grieving before their cat is gone because they are already carrying love, fear, responsibility, and uncertainty at the same time. Support is appropriate now, not only afterward.
ASPCA Pet Loss Hotline
A grief-support resource for people navigating pet loss or end-of-life decisions.
Association for Pet Loss and Bereavement
Online support groups, anticipatory grief resources, and memorial guidance.
Lap of Love grief support
Pet-loss support groups and articles for families facing hospice and euthanasia decisions.
Related support
Tools that can support the next conversation
Calculate nutrition needs for a senior or ill cat
Estimate daily calories when appetite or weight is part of the care plan.
Feeding guide for cats with reduced appetite
Translate food labels into portions when eating has become inconsistent.
Calculate your cat's age in human years
Use life-stage context to frame senior and geriatric care questions.
FAQ
Frequently Asked Questions About Cat Quality of Life
What is the HHHHHMM quality of life scale for cats?
The HHHHHMM Scale is a quality-of-life assessment framework developed by veterinary oncologist Dr. Alice Villalobos. It evaluates Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. Each area is scored from 0 to 10 for a maximum total of 70. A score above 35 generally supports continued hospice care with monitoring, while a lower score suggests a veterinary conversation is needed.
How do I know if my cat is suffering?
Cats often hide pain, so suffering may appear as withdrawal, hiding, reduced grooming, appetite loss, difficulty moving, changed breathing, altered purring, litter-box difficulty, or facial tension. If several signs appear together, contact your veterinarian.
What is the Feline Grimace Scale?
The Feline Grimace Scale is a cat-specific pain assessment tool that looks at ear position, eye tightening, muzzle tension, whisker position, and head position. Each action unit is scored 0, 1, or 2. Higher scores suggest more visible pain signs and should be discussed with a veterinarian.
How do I track good days vs. bad days for my cat?
Each day, mark whether your cat had a good, mixed, or difficult day. A good day may include interest in food, comfort, movement, and connection. A difficult day may include pain, hiding, labored breathing, refusal to eat, or obvious distress. When difficult days consistently outnumber good days, bring the pattern to your veterinarian.
What is home hospice care for cats?
Home hospice care is a veterinary-guided plan focused on comfort rather than cure. It may include pain control, nausea support, nutrition help, fluids, mobility adjustments, and repeated quality-of-life assessment.
How do I talk to my vet about my cat's quality of life?
Bring your assessment score, facial pain observations, and good-day log. Ask whether your cat is in pain, what comfort options remain, what decline may look like, and how you will know if comfort can no longer be maintained.